Bladder Cancer Rates Rise as Smoking Among Women Increases!

Specialists from the Urology Department at Hisar Hospital Intercontinental answered questions and shared information about bladder cancer, the 5th most common type of cancer in the world.

As the Number of Women Who Smoke Increases, So Does the Number of Women Diagnosed with Bladder Cancer!

The most important cause of bladder tumors that develop from the urothelium, the epithelium lining the urinary system from the kidney to the bladder, is smoking. Apart from nicotine, certain chemical substances in cigarettes (mainly called arylamines) are filtered into the urine and, as they are excreted, remain in contact with the urothelium for a long time, causing damage to the epithelium. The risk of bladder cancer is directly related to the duration of smoking and exposure to cigarette smoke in childhood. Bladder tumors can also occur in non-smokers; however, the risk is lower than in smokers. It is seen 4 times more often in men than in women. However, with the increase in the number of women who smoke today, the frequency of this type of cancer in women has also begun to rise.

Be More Concerned About Environmental Pollution Than Recurrent Urinary Tract Infections!

One of the most important triggers of bladder cancer, which is seen more often in smokers, is environmental pollution. Genetic deficiencies in tumor suppressor genes accelerate the development of bladder cancer and make these tumors more aggressive. In people who have very frequent recurrent urinary infections, known as chronic infections, cancers called squamous cell carcinoma may develop. However, it is not correct to say that bladder tumors develop in people who normally have urinary tract infections several times a year. Tumors can develop in patients who have had stones in the bladder for a very long time and who are neglected or untreated. But simple cystitis, which may occur several times a year, does not cause bladder tumors.

See a Physician Immediately If These Symptoms Are Present

The most important symptom of a bladder tumor is usually blood in the urine that can be seen with the naked eye. It may also be detected during routine tests, in urine analyses. Bleeding in the urine may occur and stop immediately. The patient may not take it seriously, thinking "my bleeding has stopped." These bleeding episodes may recur after 6 months or a year, lasting one day or half a day. Meanwhile, complaints such as cystitis-like symptoms, frequent urination and burning during urination can also affect the bladder muscles and reveal tumor symptoms. In order to make an early diagnosis, everyone over the age of 40 should have a urine test twice a year. However, even if the person has no complaints, it is beneficial to have a urinary system ultrasound once a year, which can also detect small tumors.

The Most Important Aid in Diagnosing Bladder Cancer: Cystoscopy…

With advances in radiology, ultrasonography detects tumors larger than 3 centimeters at a high rate. However, in suspicious cases or cases where there is a possibility of being overlooked, if there is blood in the urine but no image can be obtained on ultrasound, the most definitive and reliable diagnosis can be made using 'cystoscopy', a method in which the bladder is filled with water and the inner surfaces of the bladder are viewed with the aid of a lighted instrument.

How Are Bladder Tumors Treated? Is Surgery the Only Treatment Method?

For the initial diagnosis and to take a biopsy, we enter the bladder through the urinary canal in the penis using TUR (Transurethral Resection), a surgical method, and endoscopically remove the tumor inside the bladder, which we then send to pathology. This procedure gives us some information about how deep the tumor has grown into the layers of the bladder and how aggressive it is. This information is sufficient for the initial stage. For superficial bladder tumors, meaning tumors that have not invaded the muscle tissue of the bladder, taking a sample with TUR is sufficient. Afterwards, to prevent recurrence, we perform intravesical drug treatments in some cases. If the tumor has invaded the muscle tissue of the bladder in the sample we take, then, depending on the stage of the tumor, we perform surgeries in which the bladder is completely removed and one end is brought out through a bag (urinary diversion), or a new bladder is created. In some cases, radiotherapy combined with chemotherapy is also an effective option in the treatment of bladder tumors.

Bladder Tumors Can Recur. So Do Not Miss Your Follow-Up Checks!

Tumors located in the muscle tissue of the bladder, known as superficial bladder tumors, carry a risk of recurrence of 70% within five years, in proportion to the stage of the tumor and its degree of differentiation. With intravesical chemotherapy or immunotherapy given once a week for 6 or 8 weeks, we can reduce the 70% rate to around 30%. The risk of recurrence in the very superficial layer of the bladder and in low-risk bladder tumors is around 5%. For these, we do not administer drug treatment. In tumors that have grown somewhat deeper, the risk of recurrence and muscle involvement is 50%. These must absolutely be kept under control. If the bladder has been removed, checks are carried out to monitor the upper urinary system rather than the bladder itself, with at least one radiological imaging study per year, an ultrasound every 3 months, and blood test checks. For superficial bladder tumors, checks are carried out every 3 months in the first year, every 6 months in the second year, and then yearly thereafter. Checks generally continue for life; however, the first 5 years are very important.

To Protect Yourself From Bladder Cancer…

Absolutely stay away from cigarettes.

Eat fresh vegetables and fruit.

Do everything you can to avoid environmental pollution.

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